Advanced care unit where mechanical ventilation, ECMO, CRRT, and continuous monitoring are provided by a multidisciplinary team for life-threatening illness.
Indication
- Respiratory failure and need for mechanical ventilation
- Septic shock and circulatory failure
- Severe heart failure, cardiogenic shock, and post-major-surgery monitoring
- Acute kidney injury and need for continuous renal replacement therapy (CRRT)
- Multi-organ failure
- Severe trauma, burns, or postoperative critically ill patient follow-up
- Advanced cerebrovascular events, status epilepticus, and conditions requiring neurological intensive care
Preparation
- The admission process is performed rapidly until the patient's medical condition is clarified
- Detailed medical history and information about medications used are obtained from the family
- The consent process is conducted for invasive procedures
- Allergies, chronic illnesses, and prior intensive care history are recorded
- A visiting plan compliant with hygiene rules is established
How it's performed
- 24-hour continuous monitoring: ECG, blood pressure, SpO2, body temperature
- Invasive arterial and central venous pressure monitoring when needed
- Mechanical ventilation, oxygen, and respiratory support applications
- Advanced organ support such as ECMO (extracorporeal circulation), CRRT (continuous dialysis), and plasmapheresis
- Nutrition (enteral/parenteral), pain management, and sedation protocols
- Daily evaluation by a multidisciplinary team (nurse, physiotherapist, pharmacist, dietitian) led by the intensive care specialist
Post-procedure
- Patients with clinical improvement are stepped down and transferred to the ward
- Early mobilization and chest physiotherapy are initiated
- Nutrition and wound care plans are continued
- Post-discharge rehabilitation and follow-up appointments are scheduled
- The family's psychosocial support after prolonged intensive care is evaluated
Risks
- Ventilator-associated pneumonia and hospital-acquired infections
- Complications related to invasive catheters and tubes (bleeding, thrombosis)
- Muscle weakness and pressure ulcers due to prolonged bed dependence
- Delirium related to sedation and analgesics
- High mortality risk in multi-organ failure
FAQ
Why are patients sedated in the intensive care unit?
Sedation is used to provide comfort with mechanical ventilation, pain control, and tolerance of invasive procedures. Sedation is gradually reduced when the clinical condition allows.
Are visiting hours restricted?
Visiting hours and durations are defined for infection control and patient safety. Staying in contact with the team is important during critical periods; family briefings are provided in a planned manner.
When are ECMO or CRRT used?
ECMO is used in severe lung or heart failure; CRRT is used in acute kidney failure in hemodynamically unstable patients. The indication is determined by the intensive care specialist.
What is the recovery process like after intensive care?
After prolonged intensive care, muscle weakness, fatigue, and psychological effects may be seen. Recovery is supported by regular rehabilitation, nutritional support, and follow-up.
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